Abstract
Enterobacteriaceae are major pediatric pathogens, but little is known regarding treatment options for multidrug-resistant strains. In this study, we investigated the susceptibility patterns of healthcare- and community-associated Enterobacteriaceae isolates expressing plasmid-borne, broad-spectrum beta-lactam resistance (PBLR). Using E-test methodology, we tested susceptibility to imipenem, meropenem, ertapenem, doripenem, piperacillin-tazobactam, minocycline, tigecycline, fosfomycin, and colistin in all 90 clinical isolates (Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Salmonella enterica) which are derived from urine (n=62), blood (n=12), and other specimens (n=16). These strains are confirmed to carry PBLR determinants. Although malignancy, urogenital and neurological diseases, and multiple antibiotic exposure were present in most patients, twenty three isolates (26%) were characterized as communityassociated. Enterobacteriaceae isolates expressing PBLR retained in vitro susceptibility to colistin (100%), minocycline (72%), tigecycline (97%), and fosfomycin (92%). Five unlinked isolates (6%; two isolates of E. coli and three of K. pneumoniae) showed resistance to one or all carbapenem agents. All community-associated isolates were susceptible to carbapenems and exhibited greater susceptibility to other agents compared to healthcare-associated isolates. In our study population, carbapenems remained broadly active and colistin, fosfomycin, and tigecycline demonstrated therapeutic potential against PBLR-positive isolates. Our findings have implications for susceptibility testing and empirical antimicrobial strategies targeting serious pediatric infections.
Keywords: Enterobacteriaceae, plasmid-borne, broad-spectrum beta-lactam resistance
Anti-Infective Agents
Title:Antibiotic Options for Treatment of Pediatric Infections with Enterobacteriaceae Producing Broad Spectrum Beta-Lactamases
Volume: 10 Issue: 2
Author(s): Xuan Qin, Emmanouil Galanakis, Danielle M. Zerr and Scott J. Weissman
Affiliation:
Keywords: Enterobacteriaceae, plasmid-borne, broad-spectrum beta-lactam resistance
Abstract: Enterobacteriaceae are major pediatric pathogens, but little is known regarding treatment options for multidrug-resistant strains. In this study, we investigated the susceptibility patterns of healthcare- and community-associated Enterobacteriaceae isolates expressing plasmid-borne, broad-spectrum beta-lactam resistance (PBLR). Using E-test methodology, we tested susceptibility to imipenem, meropenem, ertapenem, doripenem, piperacillin-tazobactam, minocycline, tigecycline, fosfomycin, and colistin in all 90 clinical isolates (Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Salmonella enterica) which are derived from urine (n=62), blood (n=12), and other specimens (n=16). These strains are confirmed to carry PBLR determinants. Although malignancy, urogenital and neurological diseases, and multiple antibiotic exposure were present in most patients, twenty three isolates (26%) were characterized as communityassociated. Enterobacteriaceae isolates expressing PBLR retained in vitro susceptibility to colistin (100%), minocycline (72%), tigecycline (97%), and fosfomycin (92%). Five unlinked isolates (6%; two isolates of E. coli and three of K. pneumoniae) showed resistance to one or all carbapenem agents. All community-associated isolates were susceptible to carbapenems and exhibited greater susceptibility to other agents compared to healthcare-associated isolates. In our study population, carbapenems remained broadly active and colistin, fosfomycin, and tigecycline demonstrated therapeutic potential against PBLR-positive isolates. Our findings have implications for susceptibility testing and empirical antimicrobial strategies targeting serious pediatric infections.
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Qin Xuan, Galanakis Emmanouil, M. Zerr Danielle and J. Weissman Scott, Antibiotic Options for Treatment of Pediatric Infections with Enterobacteriaceae Producing Broad Spectrum Beta-Lactamases, Anti-Infective Agents 2012; 10 (2) . https://dx.doi.org/10.2174/2211362611208020130
DOI https://dx.doi.org/10.2174/2211362611208020130 |
Print ISSN 2211-3525 |
Publisher Name Bentham Science Publisher |
Online ISSN 2211-3533 |
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